My active 12 year old niece is, in my brother’s words, “up to four shots a day” including one that requires a 4 am wake-up. This sounds very bad and I was wondering if I should read anything into this. Does this regimen suggest a more aggressive form of diabetes than normal?

The insulin regimen is no guide to ‘severity’ of diabetes. Diabetes is either present or absent and there are many ways to manage the insulin system. However, it is unusual to have to administer shots at 4 am.

KJR

[Editor’s comment: If your niece is not being followed at a pediatric diabetes center, I suggest that you urge your brother to take her to one. This regimen is indeed highly unusual, and it sounds like she needs a careful assessment of her blood glucose patterns and treatment plan in order to devise one that it more conducive to her life-style. Her situation might well be clarified by monitoring sugar levels continuously for several days to try to sort out what’s happening in more detail. See The Continuous Glucose Monitoring System which would be available at such a center.

SS]